,i  #aaf? ,,congress  #b;d ,session  ,h4
 ,r4 #ffgd  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,may #a1 #bjbj,ms4    
,jayapal 7= h]self1 ,mr4 ,k5n$y1 ,mr4   
,blum5au]1 ,ms4 ,cl>ke ( ,new ,york1    
,mr4 ,coh51 ,mrs4 ,d+ell1 ,mr4 ,mi*ael  
,f4 ,doyle ( ,p5nsylvania1 ,mr4         
,espaillat1 ,mr4 ,ha/+s1 ,mrs4 ,hayes1  
,ms4 ,jackson ,lee1 ,mr4 ,khanna1 ,ms4  
,lee ( ,cali=nia1 ,mr4 ,l[5?al1 ,mr4    
,mc,govern1 ,ms4 ,m5g1 ,mrs4            
,napolitano1 ,mr4 ,neguse1 ,ms4 ,norton1
 ,ms4 ,ocasio-,cortez1 ,ms4 ,om>1 ,ms4  
,p+ree1 ,ms4 ,pressley1 ,mr4 ,rask91    
,ms4 ,s*ak[sky1 ,mr4 ,soto1 ,mr4        
,takano1 ,ms4 ,tlaib1 ,mr4 ,v>gas1 ,mr4 
,wel*1 ,ms4 ,gabb>d1 ,mr4 ,engel1 & ,ms4
 ,velzquez7 introduc$ ! foll[+ bill2 :i*
 0 ref]r$ to ! ,committee on ,en]gy &   
,comm]ce1 & 9 addition to ! ,committees 
on ,ways & ,means1 ,education & ,labor1 
& ,arm$ ,s]vices1 = a p]iod to be       
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    

conc]n$  ,a ,,bill  ,to ensure access to
 af=dable1 compreh5sive heal? insurance 
b5efits = c]ta9 un9sur$ individuals dur+
 ! ,,covid-#ai em]g5cy1 & to ensure     
adequate cov]age ( treatm5ts =          
,,covid-#ai "u ! ,m$ic>e & ,m$icaid     
programs & "u gr\p heal? plans & gr\p or
 individual heal? insurance cov]age1 & =
 o!r purposes4  #a4 ,%ort title ,?is    
,act may be cit$ z ! ,m$ic>e ,crisis    
,program ,act ( #bjbj4  ,i ,m$ic>e      
#aja4 ,,covid-#ai ,m$ic>e enrollm5t     
option  7a7 ,9 g5]al ,title ,,xviii ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#acie;c et seq47 is am5d$ by add+ at !  
end ! foll[+ new section3  #ahii;,c4    
,,covid-#ai ,m$ic>e enrollm5t option    
7a7 ,option  7#a7 ,eligibility ,e       
individual :o meets ! requirem5ts       
describ$ 9 p>agraph 7#b7 %all be        
eligible to enroll "u ?is section4  7#b7
 ,requirem5ts ,= purposes ( p>agraph    
7#a71 ! requirem5ts describ$ 9 ?is      
p>agraph are ! foll[+3 7,a7 ,!          
individual-- 7i7 exp]i5c$ a loss (1 or  

r$uction 91 employm5t dur+ ! specifi$   
p]iod 7z def9$ 9 subsection 7h77 & 0    
approv$ = unemploym5t b5efits relat+ to 
su* loss or r$uction 9 ! ,/ate 9 :i* su*
 individual resides2 or  7ii7 is !      
sp\se1 *ild1 or o!r dep5d5t ( an        
individual describ$ 9 clause 7i74  7,b7 
,! individual is n-- 7i7 o!rwise entitl$
 to b5efits "u "p ,a or eligible to     
enroll "u "p ,a or "p ,b2  7ii7 enroll$ 
"u a ,f$]al heal? c>e program 7z def9$ 9
 section #aabh;,b7f77 or ! program      
e/abli%$ "u *apt] #hi ( title #e1 ,unit$
 ,/ates ,code2  7iii7 enroll$ "u an     
eligible employ]-sponsor$ plan 7z def9$ 
9 section #ejjj;,a7f77#b7 ( ! ,int]nal  
,rev5ue ,code ( #aihf71 b only if su*   
plan-- 7,i7 includes ! ess5tial heal?   
b5efits package 7z def9$ 9 section      
#acjb7;a7 ( ! ,pati5t ,protection &     
,af=dable ,c>e ,act72 &  7,,ii7 !       
employee's requir$ contribution 7)9 !   
mean+ ( section #ejjj;,a7e77#a77;,b7 (  
su* ,code1 except t su* contribution    
%all be det]m9$ ) respect to self-only  

or family cov]age1 z applicable to !    
employee7 ) respect to ! plan does n    
exce$ ! p]c5tage specifi$ 9 section     
#cf;,b7c77#b77;,c77i77,,ii7 ( su* ,code 
= ! applicable ye>2 or  7iv7 enroll$ "u 
a qualifi$ heal? plan 7z def9$ 9 section
 #acja7;a7 ( su* ,act74  7#c7 ,b5efits  
,an individual enroll$ "u ?is section is
 entitl$ to ! same b5efits "u ?is title 
z an individual :o is entitl$ to b5efits
 "u "p ,a & enroll$ "u "p ,b &1 at !    
option ( ! individual1 eligible =       
prescription drug b5efits "u "p ,d4  7b7
 ,enrollm5t & cov]age p]iods ,!         
,secret>y %all e/abli% enrollm5t &      
cov]age p]iods = individuals :o enroll  
"u ?is section4 ,a cov]age p]iod )      
respect to an individual enroll$ "u ?is 
section %all be retroactive to ! date on
 :i* ! individual exp]i5c$ ! loss or    
r$uction describ$ 9 subsection          
7a77#b77;,a77i74  7c7 ,enrollm5t premium
  7#a7 ,am\nt ( mon?ly premiums ,!re    
%all be no mon?ly premium = an          
individual enroll$ "u ?is section except

 z provid$ 9 p>agraph 7#b74  7#b7       
,premium = optional "p ,d b5efits ,9 !  
case an individual enroll$ "u ?is       
section elects to receive cov]age "u a  
prescription drug plan "u "p ,d1 !re    
%all be a mon?ly premium ) respect to   
su* individual 9 an am\nt det]m9$       
appropriate by ! ,secret>y4  7d7 ,paym5t
 ( premiums  7#a7 ,paym5t ,premiums =   
enrollm5t "u ?is section %all be paid to
 ! ,secret>y at su* times1 & 9 su*      
mann]1 z ! ,secret>y det]m9es           
appropriate4  7#b7 ,deposit ,am\nts     
collect$ by ! ,secret>y "u ?is section  
%all be deposit$ 9 ! ,m$ic>e ,,covid-#ai
 ,tru/ ,fund e/abli%$ "u subsection 7e74
  7e7 ,m$ic>e ,,covid-#ai ,tru/ ,fund   
7#a7 ,9 g5]al ,!re is h]eby creat$ on ! 
books ( ! ,treasury ( ! ,unit$ ,/ates a 
tru/ fund to be kn[n z ! ,m$ic>e        
,,covid-#ai ,tru/ ,fund 79 ?is          
subsection ref]r$ to z ! ,tru/ ,fund74  
,! ,tru/ ,fund %all consi/ ( su* gifts &
 beque/s z may be made & su* am\nts z   
may be deposit$ 91 or appropriat$ to1   

su* fund z provid$ 9 ?is title4  7#b7   
,premiums ,premiums collect$ "u         
subsection 7d7 %all be transf]r$ to !   
,tru/ ,fund4  7#c7 ,incorporation (     
,provisions ,subsections 7b7 ?r\gh 7i7 (
 section #ahda %all apply ) respect to !
 ,tru/ ,fund & ?is title 9 ! same mann] 
z !y apply ) respect to ! ,f$]al        
,supplem5t>y ,m$ical ,insurance ,tru/   
,fund & "p ,b1 respectively1 except t 9 
apply+ su* section #ahda1 any ref]5ce 9 
su* section to ?is "p %all be con/ru$ to
 be a ref]5ce to ?is section & any      
ref]5ce 9 section #ahda7;h7 to section  
#ahdj7;d7 & 9 section #ahda7;i7 to      
sections #ahdj7;b77#a7 & #ahdb7;g7 are  
deem$ to be ref]5ces to comp>able       
au?ority ex]cis$ "u ?is section4  7f7   
,t]m9ation ( cov]age ,cov]age ( an      
individual enroll$ "u ?is section %all  
t]m9ate on ! e>lie/ ( ! foll[+3 7#a7 ,! 
date on :i* ! individual becomes entitl$
 to b5efits "u "p ,a or eligible to     
enroll "u su* "p ,a or "p ,b 7z det]m9$ 
)\t reg>d to ?is section74  7#b7 ,! date

 on :i* ! individual becomes enroll$ 9  
cov]age describ$ 9 any ( clauses 7ii7   
?r\gh 7iv7 ( subsection 7a77#b77;,b7 7z 
det]m9$ )\t reg>d to ?is section74  7#c7
 ,! end ( ! specifi$ p]iod 7z def9$ 9   
subsection 7h77 ) respect to su*        
individual4  7g7 ,enrollm5t in=mation   
7#a7 ,guidance ,! ,secret>y ( ,labor    
%all publi% guidance = ,/ates ) respect 
to in=mation to be includ$ by ,/ates on 
unemploym5t portals = purposes (        
facilitat+ enrollm5t ( individuals "u   
?is section4  7#b7 ,provision (         
in=mation to ,,cms ,9 ! case ( a claim =
 unemploym5t b5efits submitt$ to a ,/ate
 t indicates t ! individual may be      
eligible = enrollm5t "u ?is section1 !  
,/ate %all provide su* in=mation reg>d+ 
su* individual z ! ,secret>y may specify
 to ! ,secret>y4  7#c7 ,onl9e enrollm5t 
,! ,secret>y %all create an onl9e       
application =m to facilitate enrollm5t  
"u ?is section4  7h7 ,specifi$ p]iod    
7#a7 ,9 g5]al ,9 ?is section1 ! t]m     
specific p]iod means1 ) respect to an   

individual resid+ 9 a ,/ate1 ! date     
beg9n+ on ! fir/ day ( ! em]g5cy p]iod  
7z describ$ 9 section                   
#aace7;g77#a77;,b77 & end+ on ! date t  
is #c mon?s aft] ! fir/ day occurr+ on  
or aft] ! date ( ! enactm5t ( ?is       
section t ! av]age unemploym5t rate = ! 
#ab-mon? p]iod end+ on su* fir/ day--   
7,a7 9 su* ,/ate is n m ?an #b p]c5tage 
po9ts high] t ! av]age unemploym5t rate 
9 su* ,/ate dur+ ! p]iod consi/+ (      
,octob] #a ?r\gh ,decemb] #ca ( #bjai2 &
  7,b7 9 ! ,unit$ ,/ates is n m ?an #b  
p]c5tage po9ts high] ?an ! av]age       
unemploym5t rate 9 ! ,unit$ ,/ates dur+ 
! p]iod consi/+ ( ,octob] #a ?r\gh      
,decemb] #ca ( #bjai4  7#b7 ,notice ,9 !
 case ( an individual enroll$ "u ?is    
section1 if ! specifi$ p]iod ) respect  
to su* individual ends :ile su*         
individual is s enroll$1 ! ,secret>y    
%all provide notice to su* individual ( 
! end ( su* p]iod & an explanation t    
cov]age "u ?is section %all t]m9ate )   
respect to su* individual n lat] ?an !  

date t is #c mon?s aft] ! end ( su*     
p]iod4  7i7 ,fund+ ,!re is appropriat$1 
out ( any monies 9 ! ,treasury n o!rwise
 obligat$1 to ! ,tru/ ,fund describ$ 9  
subsection 7e7 su* sums z may be        
necess>y to c>ry out ?is section        
7includ+ = ! paym5t ( "p ,a & "p ,b     
b5efits = individuals enroll$ "u ?is    
section74  4  7b7 ,m$igap ,section #ahhb
 ( ! ,social ,security ,act is am5d$ by 
add+ at ! end ! foll[+ new subsection3  
7aa7 ,developm5t ( ,new ,/&>ds = ,c]ta9 
,m$ic>e ,supplem5tal ,policies relat+ to
 ,,covid-#ai enrollm5t option ,!        
,secret>y %all reque/ ! ,national       
,association ( ,insurance ,commission]s 
to review & revise ! /&>ds = b5efit     
packages describ$ 9 subsection 7p77#a71 
to o!rwise update /&>ds to include      
requirem5ts = ea* m$ic>e supplem5tal    
policy t (f]s su* a policy 9 a ,/ate1 ) 
respect to ea* ye>1 to accept e         
individual 9 ! ,/ate :o is enroll$      
pursuant to section #ahii;,c & :o       
applies = su* cov]age = su* ye> if !    

individual applies = enrollm5t 9 su*    
policy dur+ ! #cj-;day p]iod foll[+ !   
date ( enrollm5t pursuant to section    
#ahii;,c & to accept e su* individual   
dur+ a p]iod ( transition f enrollm5t   
pursuant to su* section to enrollm5t "u 
?is title pursuant to eligibility o!r   
?an "u su* section4 ,su* revisions %all 
be made consi/5t ) ! rules applicable "u
 subsection 7p77#a77;,e7 ) ! ref]5ce to 
! #aiia ,,naic ,model ,regulation deem$ 
a ref]5ce to ! ,,naic ,model ,regulation
 z publi%$ 9 ! ,f$]al ,regi/] on        
,decemb] #d1 #aiih1 & z subsequ5tly     
updat$ by ! ,national ,association (    
,insurance ,commission]s to reflect     
previ\s *anges 9 law & ! ref]5ce to date
 ( enactm5t ( ?is subsection deem$ a    
ref]5ce to ! date ( enactm5t ( ?is      
subsection 7aa74  4  #ajb4 ,hold+       
,m$ic>e b5efici>ies h>mless = specifi$  
,,covid-#ai treatm5t s]vices furni%$ "u 
"p ,a or "p ,b ( ! ,m$ic>e program  7a7 
,9 g5]al ,not)/&+ any o!r provision (   
law1 9 ! case ( a specifi$ ,,covid-#ai  

treatm5t s]vice 7z def9$ 9 subsection   
7b77 furni%$ to an individual entitl$ to
 b5efits "u "p ,a or enroll$ "u "p ,b ( 
title ,,xviii ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acie et seq47 or       
enroll$ "u section #ahii;,c ( ! ,social 
,security ,act = :i* paym5t is made "u  
su* "p ,a or su* "p ,b1 ! ,secret>y (   
,heal? & ,human ,s]vices 79 ?is section 
ref]r$ to z ! ,secret>y7 %all provide   
t-- 7#a7 any co/ %>+ requir$ 7includ+   
any d$uctible1 copaym5t1 or co9surance7 
applicable to su* individual "u su* "p  
,a or su* "p ,b ) respect to su* item or
 s]vice is paid by ! ,secret>y2  7#b7 ! 
provid] ( s]vices or suppli] 7z def9$ 9 
section #ahfa ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #aciex77 does n hold su*
 individual liable = su* requirem5t2 &  
7#c7 no prior au?orization or o!r       
utilization managem5t requirem5t is     
appli$ ) respect to su* s]vice4  7b7    
,def9ition ( specifi$ ,,covid-#ai       
treatm5t s]vices ,= purposes ( ?is      
section1 ! t]m specifi$ ,,covid-#ai     

treatm5t s]vice means any item or       
s]vice-- 7#a7 relat+ to ! treatm5t or   
diagnosis ( ,,covid-#ai2  7#b7 furni%$  
to an individual 9 an em]g5cy dep>tm5t  
:]e su* individual pres5ts ) ,,covid-#ai
 symptoms2 or  7#c7 9 ! case ( an       
individual furni%$ a te/ = ,,covid-#ai  
or diagnos$ ) ,,covid-#ai1 furni%$ dur+ 
! same episode ( c>e z su* te/ or       
diagnosis1 reg>dless ( sett+4  7c7      
,recov]y ( co/-,%>+ am\nts paid by !    
,secret>y 9 ! case ( supplem5tal        
insurance cov]age  7#a7 ,9 g5]al ,9 !   
case ( any am\nt paid by ! ,secret>y    
pursuant to subsection 7a77#a7 t !      
,secret>y det]m9es w\ld o!rwise h be5   
paid by a gr\p heal? plan or heal?      
insurance issu] 7z su* t]ms are def9$ 9 
section #bgia ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4 #cjj;gg-#ia771 a   
private entity (f]+ a m$ic>e supplem5tal
 policy "u section #ahhb ( ! ,social    
,security ,act 7#db ,u4,s4,c4 #aciess71 
any o!r heal? plan (f]+ supplem5tal     
cov]age1 a ,/ate plan "u title ,,xix ( !

 ,social ,security ,act1 or ! ,secret>y 
( ,def5se "u ! ,,tric>e program1 su*    
plan1 issu]1 private entity1 o!r heal?  
plan1 ,/ate plan1 or ,secret>y (        
,def5se1 z applicable1 %all pay to !    
,secret>y1 n lat] ?an #a ye> aft] su*   
plan1 issu]1 private entity1 o!r heal?  
plan1 ,/ate plan1 or ,secret>y ( ,def5se
 receives a notice "u p>agraph 7#c71 su*
 am\nt 9 accordance ) ?is subsection4   
7#b7 ,requir$ in=mation ,n lat] ?an #i  
mon?s aft] ! date ( ! enactm5t ( ?is    
,act1 ea* gr\p heal? plan1 heal?        
insurance issu]1 private entity1 o!r    
heal? plan1 ,/ate plan1 & ,secret>y (   
,def5se describ$ 9 p>agraph 7#a7 %all   
submit to ! ,secret>y su* in=mation z ! 
,secret>y det]m9es necess>y = purposes (
 c>ry+ out ?is subsection4 ,su*         
in=mation s submitt$ %all be updat$ by  
su* plan1 issu]1 private entity1 o!r    
heal? plan1 ,/ate plan1 or ,secret>y (  
,def5se1 z applicable1 at su* "t & 9 su*
 mann] z specifi$ by ! ,secret>y4  7#c7 
,review ( claims & notification ,!      

,secret>y %all e/abli% a process "u :i* 
claims = items & s]vices = :i* !        
,secret>y has paid an am\nt pursuant to 
subsection 7a77#a7 are review$ =        
purposes ( id5tify+ if su* am\nt w\ld   
o!rwise h be5 paid by a plan1 issu]1    
private entity1 o!r heal? plan1 ,/ate   
plan1 or ,secret>y ( ,def5se describ$ 9 
p>agraph 7#a74 ,9 ! case su* a claim is 
s id5tifi$1 ! ,secret>y %all det]m9e !  
am\nt t w\ld h be5 o!rwise payable by   
su* plan1 issu]1 private entity1 o!r    
heal? plan1 ,/ate plan1 or ,secret>y (  
,def5se & notify su* plan1 issu]1       
private entity1 o!r heal? plan1 ,/ate   
plan1 or ,secret>y ( ,def5se ( su*      
am\nt4  7#d7 ,en=cem5t ,! ,secret>y may 
impose a civil monet>y p5alty 9 an am\nt
 det]m9$ appropriate by ! ,secret>y 9 ! 
case ( a plan1 issu]1 private entity1   
o!r heal? plan1 or ,/ate plan t fails to
 comply ) a provision ( ?is section4 ,! 
provisions ( section #aabh;,a ( !       
,social ,security ,act %all apply to a  
civil monet>y p5alty impos$ "u ! previ\s

 s5t5ce 9 ! same mann] z su* provisions 
apply to a p5alty or proce$+ "u         
subsection 7a7 or 7b7 ( su* section4    
7d7 ,fund+ ,! ,secret>y %all provide = !
 transf] to ! ,c5t]s = ,m$ic>e  ,m$icaid
 ,program ,managem5t ,acc\nt f ! ,f$]al 
,hospital ,insurance ,tru/ ,fund & !    
,f$]al ,supplem5t>y ,tru/ ,fund 79 su*  
portions z ! ,secret>y det]m9es         
appropriate7 #ajj1jjj1jjj = purposes (  
c>ry+ out ?is section4  7e7 ,report ,n  
lat] ?an #c ye>s aft] ! date ( !        
enactm5t ( ?is ,act1 ! ,inspector ,g5]al
 ( ! ,dep>tm5t ( ,heal? & ,human        
,s]vices %all submit to ,congress a     
report conta9+ an analysis ( am\nts paid
 pursuant to subsection 7a77#a7 comp>$  
to am\nts paid to ! ,secret>y pursuant  
to subsection 7c74  7f7 ,implem5tation  
,not)/&+ any o!r provision ( law1 !     
,secret>y may implem5t ! provisions (   
?is section by program in/ruction or    
o!rwise4  #ajc4 ,cov]age ( treatm5ts =  
,,covid-#ai at no co/ %>+ "u ! ,m$ic>e  
,advantage program  7a7 ,9 g5]al        

,section #aheb7;a77#a77;,b7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#aciew-#bb7;a77#a77;,b77 is am5d$ by    
add+ at ! end ! foll[+ new clause3      
7vii7 ,special cov]age rules = specifi$ 
,,covid-#ai treatm5t s]vices ,not)/&+   
clause 7i71 9 ! case ( a specifi$       
,,covid-#ai treatm5t s]vice 7z def9$ 9  
section #ajb7;b7 ( ! ,m$ic>e ,crisis    
,program ,act ( #bjbj7 t is furni%$ dur+
 a plan ye> occurr+ dur+ any portion ( !
 em]g5cy p]iod def9$ 9 section          
#aace7;g77#a77;,b7 beg9n+ on or aft] !  
date ( ! enactm5t ( ?is clause1 a       
,m$ic>e ,advantage plan may n1 ) respect
 to su* s]vice1 impose-- 7,i7 any       
co/-%>+ requirem5t 7includ+ a d$uctible1
 copaym5t1 or co9surance requirem5t72 & 
7,,ii7 any prior au?orization or o!r    
utilization managem5t requirem5t4  ,a   
,m$ic>e ,advantage plan may n take !    
application ( ?is clause into acc\nt =  
purposes ( a bid am\nt submitt$ by su*  
plan "u section #ahed7;a77#f74  4  7b7  
,reimbursem5t ( ,m$ic>e ,advantage plans

 = elim9ation ( co/ %>+ ,section #ahec (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #aciew-#bc7 is am5d$ by add+ at ! end !
 foll[+ new subsection3  7p7 ,additional
 paym5t ,to acc\nt = co/ %>+ elim9ation 
= ,,covid-#ai treatm5t s]vices  7#a7 ,9 
g5]al ,a ,m$ic>e ,advantage plan %all   
notify ! ,secret>y ( ! total doll> am\nt
 ( co/ %>+ t1 b = ! application (       
section #aheb7;a77#a77;,b77vii71 w\ld h 
be5 requir$ "u su* plan = specifi$      
,,covid-#ai treatm5t s]vices 7z def9$ 9 
section #gjbjb7;b7 ( ! ,take            
,responsibility = ,work]s & ,families   
,act7 furni%$ dur+ a plan ye> describ$ 9
 su* section to individuals enroll$ 9 ! 
plan4 ,! ,secret>y %all make p]iodic &  
timely paym5ts 9 accordance ) ?is       
subsection to su* plan t1 9 ! aggregate1
 equal su* total doll> am\nt4  7#b7     
,tim+ ( paym5t ,paym5ts by ! ,secret>y  
"u ?is subsection %all be made beg9n+   
,m>* #a1 #bjba1 = am\nts describ$ 9 su* 
p>agraph t w\ld h be5 requir$ "u su*    
plan = specifi$ ,,covid-#ai treatm5t    

s]vices furni%$ dur+ plan ye> #bjbj4    
,paym5ts by ! ,secret>y "u ?is          
subsection = su* am\nts t w\ld h be5 s  
requir$ "u su* plan = su* s]vices       
furni%$ dur+ a plan ye> subsequ5t to    
plan ye> #bjbj %all be made beg9n+ ,m>* 
#a ( ! plan ye> foll[+ su* subsequ5t    
plan ye>4  7#c7 ,non-application        
,section #ahec7;c77#g7 %all n apply )   
respect to ! application ( ?is          
subsection4  7#d7 ,appropriation ,!re   
are transf]r$ to ! ,c5t]s = ,m$ic>e     
,m$icaid ,program ,managem5t ,fund1 out 
( any monies 9 ! ,treasury n o!rwise    
obligat$1 su* sums z may be necess>y to 
! ,secret>y = purposes ( mak+ paym5ts "u
 ?is subsection4  4  7c7 ,implem5tation 
,not)/&+ any o!r provision ( law1 !     
,secret>y ( ,heal? & ,human ,s]vices may
 implem5t ! am5dm5ts made by ?is section
 by program in/ruction or o!rwise4      
#ajd4 ,gu>ante$ issue ( c]ta9 ,m$igap   
policies  7a7 ,gu>ante$ issue ( ,m$igap 
policies to all ,m$igap-,eligible       
,m$ic>e b5efici>ies  7#a7 ,9 g5]al      

,section #ahhb7s7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #aciess7s77 is      
am5d$-- 7,a7 9 p>agraph 7#b77;,a71 by   
/rik+ #fe ye>s ( age or old] & is       
enroll$ = b5efits "u "p ,b & ins]t+     
entitl$ to1 or enroll$ =1 b5efits "u "p 
,a & enroll$ = b5efits "u "p ,b2  7,b7 9
 p>agraph 7#b77;,d71 by /rik+ :o is #fe 
ye>s ( age or old] z ( ! date ( issuance
 &2  7,c7 9 p>agraph 7#c77;,b77ii71 by  
/rik+ is #fe ye>s ( age or old] &2 &    
7,d7 9 p>agraph 7#c77;,b77vi71 by /rik+ 
at age #fe4  7#b7 ,additional enrollm5t 
p]iod = c]ta9 individuals  7,a7 ,"o-"t  
enrollm5t p]iod  7i7 ,9 g5]al ,9 ! case 
( a specifi$ individual1 ! ,secret>y    
%all e/abli% a "o-"t enrollm5t p]iod    
describ$ 9 clause 7iii7 dur+ :i* su* an 
individual may enroll 9 any m$ic>e      
supplem5tal policy ( ! individual's     
*oos+4  7ii7 ,application ,! provisions 
(-- 7,i7 p>agraph 7#b7 ( section        
#ahhb7s7 ( ! ,social ,security ,act 7#db
 ,u4,s4,c4 #aciess7s77 %all apply )     
respect to a specifi$ individual :o is  

describ$ 9 subclause 7,i7 ( subp>agraph 
7,b77iii7 z if ref]5ces 9 su* p>agraph  
7#b7 to ! #f-mon? p]iod describ$ 9      
subp>agraph 7,a7 ( su* p>agraph 7       
ref]5ces to ! "o-"t enrollm5t p]iod     
e/abli%$ "u clause 7i72 &  7,,ii7       
p>agraph 7#c7 ( su* section %all apply )
 respect to a specifi$ individual :o is 
describ$ 9 subclause 7,,ii7 (           
subp>agraph 7,b77iii7 z if ref]5ces 9   
su* p>agraph 7#c7 to ! p]iod specifi$ 9 
subp>agraph 7,e7 ( su* p>agraph 7       
ref]5ces to ! "o-"t enrollm5t p]iod     
e/abli%$ "u clause 7i74  7iii7 ,p]iod ,!
 enrollm5t p]iod e/abli%$ "u clause 7i7 
%all be ! #f-mon? p]iod beg9n+ on       
,janu>y #a1 #bjbd4  7,b7 ,specifi$      
individual ,= purposes ( ?is p>agraph1 !
 t]m specifi$ individual means an       
individual :o-- 7i7 is entitl$ to       
hospital insurance b5efits "u "p ,a (   
title ,,xviii ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acie;c et seq47        
pursuant to section #bbf7;b7 or section 
#bbf;,a ( su* ,act 7#db ,u4,s4,c4       

#dbf7;b72 #dbf-a72  7ii7 is enroll$ =   
b5efits "u "p ,b ( su* ,act 7#db        
,u4,s4,c4 #acie;j et seq472 &  7iii7    
7,i7 w\ld n1 b = ! am5dm5ts made by     
subp>agraphs 7,a7 & 7,b7 ( p>agraph 7#a7
 & ! provisions ( ?is p>agraph 7if su*  
provisions appli$ to su* individual71 be
 eligible = ! gu>ante$ issue ( a m$ic>e 
supplem5tal policy "u p>agraph 7#b7 (   
section #ahhb7s7 ( su* ,act 7#db        
,u4,s4,c4 #aciess7s772 or  7,,ii7 w\ld  
n1 b = ! am5dm5ts made by subp>agraphs  
7,c7 & 7,d7 ( p>agraph 7#a7 & !         
provisions ( ?is p>agraph 7if su*       
provisions appli$ to su* individual71 be
 eligible = ! gu>ante$ issue ( a m$ic>e 
supplem5tal policy "u p>agraph 7#c7 (   
su* section4  7,c7 ,outrea* plan  7i7 ,9
 g5]al ,! ,secret>y %all develop an     
outrea* plan to notify specifi$         
individuals ( ! "o-"t enrollm5t p]iod   
e/abli%$ "u subp>agraph 7,a74  7ii7     
,consultation ,9 implem5t+ ! outrea*    
plan develop$ "u clause 7i71 ! ,secret>y
 %all consult ) consum] advocates1      

brok]s1 insur]s1 ! ,national            
,association ( ,insurance ,commission]s1
 & ,/ate ,heal? ,insurance ,assi/ance   
,programs4  7#c7 ,effective date ,!     
am5dm5ts made by p>agraph 7#a7 %all     
apply to m$ic>e supplem5tal policies    
effective on or aft] ! date ( ! enactm5t
 ( ?is ,act4  7b7 ,gu>ante$ issue (     
,m$igap policies = ,m$ic>e ,advantage   
enrollees  7#a7 ,9 g5]al ,section       
#ahhb7s77#c7 ( ! ,social ,security ,act 
7#db ,u4,s4,c4 #aciess7s77#c771 z am5d$ 
by subsection 7a71 is fur!r am5d$-- 7,a7
 9 subp>agraph 7,b71 by add+ at ! end ! 
foll[+ new clause3  7vii7 ,!            
individual-- 7,i7 0 enroll$ 9 a ,m$ic>e 
,advantage plan "u "p ,c = n less ?an   
#ab mon?s2  7,,ii7 subsequ5tly dis5roll$
 f su* plan2  7,,iii7 elects to receive 
b5efits "u ?is title ?r\gh ! orig9al    
,m$ic>e fee-=-s]vice program "u p>ts ,a 
& ,b2 &  7,,iv7 has n previ\sly elect$  
to receive b5efits "u ?is title ?r\gh ! 
orig9al ,m$ic>e fee-=-s]vice program    
pursuant to dis5rollm5t f a ,m$ic>e     

,advantage plan "u "p ,c4  2  7,b7 by   
/rik+ subp>agraph 7,c77iii7 & ins]t+ !  
foll[+3  7iii7 ,subject to subsection   
7v77#a71 = purposes ( an individual     
describ$ 9 clause 7vi7 or 7vii7 (       
subp>agraph 7,b71 a m$ic>e supplem5tal  
policy describ$ 9 ?is subp>agraph %all  
include any m$ic>e supplem5tal policy4  
2 &  7,c7 9 subp>agraph 7,e7-- 7i7 9    
clause 7iv71 by /rik+ & at ! end2  7ii7 
9 clause 7v71 by /rik+ ! p]iod at ! end 
& ins]t+ 2 &2 &  7iii7 by add+ at ! end 
! foll[+ new clause--  7vi7 9 ! case (  
an individual describ$ 9 subp>agraph    
7,b77vii71 ! annual1 coord9at$ election 
p]iod 7z def9$ 9 section                
#ahea7;e77#c77;,b77 or a cont9u\s op5   
enrollm5t p]iod 7z def9$ 9 section      
#ahea7;e77#b77 dur+ :i* ! individual    
dis5rolls f a ,m$ic>e ,advantage plan "u
 "p ,c4  4  7#b7 ,effective date ,!     
am5dm5ts made by p>agraph 7#a7 %all     
apply to m$ic>e supplem5tal policies    
effective on or aft] ! date ( ! enactm5t
 ( ?is ,act4  #aje4 ,requir+ cov]age "u 

,m$ic>e ,p,d,ps & ,,ma-,,pd plans1 )\t !
 imposition ( co/ %>+ or utilization    
managem5t requirem5ts1 ( drugs int5d$ to
 treat ,,covid-#ai dur+ c]ta9 em]g5cies 
7a7 ,cov]age requirem5t  7#a7 ,9 g5]al  
,section #ahfj;,d-#d7;b77#c7 ( ! ,social
 ,security ,act 7#db ,u4,s4,c4          
#aciew-#ajd7;b77#c77 is am5d$ by add+ at
 ! end ! foll[+ new subp>agraph3  7,i7  
,requir$ inclusion ( drugs int5d$ to    
treat ,,covid-#ai  7i7 ,9 g5]al ,not)/&+
 any o!r provision ( law1 a ,,pdp       
sponsor (f]+ a prescription drug plan   
%all1 ) respect to a plan ye>1 any      
portion ( :i* occurs dur+ ! p]iod       
describ$ 9 clause 7ii71 be requir$ to-- 
7,i7 include 9 any =mul>y-- 7aa7 all    
cov]$ "p ,d drugs ) a m$ically accept$  
indication 7z def9$ 9 section           
#ahfj;,d-#b7;e77#d77 to treat           
,,covid-#ai t are m>ket$ 9 ! ,unit$     
,/ates2 &  7bb7 all drugs au?oriz$ "u   
section #efd or #efd;,a ( ! ,f$]al      
,food1 ,drug1 & ,cosmetic ,act to treat 
,,covid-#ai2 &  7,,ii7 n impose any     

prior au?orization or o!r utilization   
managem5t requirem5t ) respect to su*   
drugs describ$ 9 item 7aa7 or 7bb7 (    
subclause 7,i7 7o!r ?an su* a requirem5t
 t limits ! quantity ( drugs due to     
safety74  7ii7 ,p]iod describ$ ,=       
purposes ( clause 7i71 ! p]iod describ$ 
9 ?is clause is ! p]iod dur+ :i* !re    
exi/s ! public heal? em]g5cy decl>$ by !
 ,secret>y pursuant to section #cai ( ! 
,public ,heal? ,s]vice ,act on ,janu>y  
#ca1 #bjbj1 entitl$ ,det]m9ation t a    
,public ,heal? ,em]g5cy ,exi/s          
,nationwide z ! ,result ( ! #bjai ,novel
 ,coronavirus 7includ+ any r5ewal ( su* 
decl>ation pursuant to su* section74  4 
7b7 ,elim9ation ( co/ %>+  7#a7         
,elim9ation ( co/ %>+ = drugs int5d$ to 
treat ,,covid-#ai "u /&>d & alt]native  
prescription drug cov]age ,section      
#ahfj;,d-#b ( ! ,social ,security ,act  
7#db ,u4,s4,c4 #aciew-#ajb7 is am5d$--  
7,a7 9 subsection 7b7-- 7i7 9 p>agraph  
7#a77;,a71 by /rik+ ,! cov]age & ins]t+ 
,subject to p>agraph 7#h71 ! cov]age2   

7ii7 9 p>agraph 7#b7-- 7,i7 9           
subp>agraph 7,a71 by ins]t+ aft]        
,subject to subp>agraphs 7,c7 & 7,d7 !  
foll[+3 & p>agraph 7#h72  7,,ii7 9      
subp>agraph 7,c77i71 by /rik+ p>agraph  
7#d7 & ins]t+ p>agraphs 7#d7 & 7#h72 &  
7,,iii7 9 subp>agraph 7,d77i71 by /rik+ 
p>agraph 7#d7 & ins]t+ p>agraphs 7#d7 & 
7#h72  7iii7 9 p>agraph 7#d77;,a77i71 by
 /rik+ ,! cov]age & ins]t+ ,subject to  
p>agraph 7#h71 ! cov]age2 &  7iv7 by    
add+ at ! end ! foll[+ new p>agraph3    
7#h7 ,elim9ation ( co/-%>+ = drugs      
int5d$ to treat ,,covid-#ai ,! cov]age  
does n impose any d$uctible1 copaym5t1  
co9surance1 or o!r co/-%>+ requirem5t = 
drugs describ$ 9 section                
#ahfj;,d-#d7;b77#c77;,i77i77,i7 )       
respect to a plan ye>1 any portion ( :i*
 occurs dur+ ! p]iod dur+ :i* !re exi/s 
! public heal? em]g5cy decl>$ by !      
,secret>y pursuant to section #cai ( !  
,public ,heal? ,s]vice ,act on ,janu>y  
#ca1 #bjbj1 entitl$ ,det]m9ation t a    
,public ,heal? ,em]g5cy ,exi/s          

,nationwide z ! ,result ( ! #bjai ,novel
 ,coronavirus 7includ+ any r5ewal ( su* 
decl>ation pursuant to su* section74  2 
&  7,b7 9 subsection 7c71 by add+ at !  
end ! foll[+ new p>agraph3  7#d7 ,same  
elim9ation ( co/-%>+ = drugs int5d$ to  
treat ,,covid-#ai ,! cov]age is 9       
accordance ) subsection 7b77#h74  4     
7#b7 ,elim9ation ( co/ %>+ = drugs      
int5d$ to treat ,,covid-#ai disp5s$ to  
individuals :o are subsidy eligible     
individuals ,section #ahfj;,d-#ad7;a7 ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#aciew-#aad7;a77 is am5d$-- 7,a7 9      
p>agraph 7#a7-- 7i7 9 subp>agraph 7,d7--
 7,i7 9 clause 7ii71 by /rik+ ,9 ! case 
( & ins]t+ ,subject to subp>agraph 7,f71
 9 ! case (2 &  7,,ii7 9 clause 7iii71  
by /rik+ ,9 ! case ( & ins]t+ ,subject  
to subp>agraph 7,f71 9 ! case (2 &  7ii7
 by add+ at ! end ! foll[+ new          
subp>agraph3  7,f7 ,elim9ation ( co/-%>+
 = drugs int5d$ to treat ,,covid-#ai    
,cov]age t is 9 accordance ) section    
#ahfj;,d-#b7;b77#h74  2 &  7,b7 9       

p>agraph 7#b7-- 7i7 9 subp>agraph 7,b71 
by /rik+ ,a r$uction & ins]t+ ,subject  
to subp>agraph 7,f71 a r$uction2  7ii7 9
 subp>agraph 7,d71 by /rik+ ,!          
sub/itution & ins]t+ ,subject to        
subp>agraph 7,f71 ! sub/itution2  7iii7 
9 subp>agraph 7,e71 by ins]t+ aft]      
,subject to ! foll[+3 subp>agraph 7,f7  
&2 &  7iv7 by add+ at ! end ! foll[+ new
 subp>agraph3  7,f7 ,elim9ation (       
co/-%>+ = drugs int5d$ to treat         
,,covid-#ai ,cov]age t is 9 accordance )
 section #ahfj;,d-#b7;b77#h74  4  7c7   
,,lis eligibility ,section              
#ahfj;,d-#ad7;a77#c77;,c77i7 ( ! ,social
 ,security ,act 7#db ,u4,s4,c4          
#aciew-#aad7;a77#c77;,c77i77 is am5d$ by
 ins]t+ & any am\nts receiv$ f a ,/ate z
 unemploym5t b5efits aft] furni%$ 9 k9d4
  7d7 ,implem5tation ,not)/&+ any o!r   
provision ( law1 ! ,secret>y ( ,heal? & 
,human ,s]vices may implem5t ! am5dm5ts 
made by ?is section by program          
in/ruction or o!rwise4  #ajf4 ,m$ic>e   
special enrollm5t p]iod = individuals   

resid+ 9 ,,covid-#ai em]g5cy areas  7a7 
,9 g5]al ,section #ahcg7;i7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4 #aciep7i77
 is am5d$ by add+ at ! end ! foll[+ new 
p>agraph3  7#e7 7,a7 ,9 ! case ( an     
individual :o-- 7i7 is eligible "u      
section #ahcf to enroll 9 ! m$ical      
insurance program e/abli%$ by ?is "p2   
7ii7 has elect$ n to enroll 7or to be   
deem$ enroll$7 "u su* section dur+ an   
enrollm5t p]iod2 &  7iii7 dur+ ! em]g5cy
 p]iod 7z describ$ 9 section            
#aace7;g77#a77;,b771 is resid+ 9 an     
em]g5cy area 7z describ$ 9 su* section71
  !re %all be a special enrollm5t p]iod 
describ$ 9 subp>agraph 7,b74  7,b7 ,!   
special enrollm5t p]iod ref]r$ to 9     
subp>agraph 7,a7 is1 ) respect to an    
individual resid+ 9 a ,/ate1 ! p]iod t  
beg9s on ! date ( ! enactm5t ( ?is      
p>agraph & ends on ! date t is #c mon?s 
aft] ! fir/ day occurr+ on or aft] !    
date ( ! enactm5t ( ?is p>agraph t !    
av]age unemploym5t rate = ! #ab-mon?    
p]iod end+ on su* fir/ day-- 7i7 9 su*  

,/ate is n m ?an #b p]c5tage po9ts high]
 t ! av]age unemploym5t rate 9 su* ,/ate
 dur+ ! p]iod consi/+ ( ,octob] #a ?r\gh
 ,decemb] #ca ( #bjai2 &  7ii7 9 !      
,unit$ ,/ates is n m ?an #b p]c5tage    
po9ts high] t ! av]age unemploym5t rate 
9 ! ,unit$ ,/ates dur+ ! p]iod consi/+ (
 ,octob] #a ?r\gh ,decemb] #ca ( #bjai4 
4  7b7 ,cov]age p]iod = individuals     
transition+ f o!r cov]age ,section      
#ahch7;e7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acieq7e77 is am5d$--    
7#a7 by /rik+ pursuant to section       
#ahcg7;i77#c7 or #ahcg7;i77#d77;,b7-- & 
ins]t+ ! foll[+3 pursuant to-- 7#a7     
section #ahcg7;i77#c7 or                
#ahcg7;i77#d77;,b7--  2  7#b7 by        
r$esignat+ p>agraphs 7#a7 & 7#b7 z      
subp>agraphs 7,a7 & 7,b71 respectively1 
& mov+ ! ind5tation ( ea* su*           
subp>agraph #b ems to ! "r2  7#c7 by    
/rik+ ! p]iod at ! end ( ! subp>agraph  
7,b71 z s r$esignat$1 & ins]t+ 2 or2 &  
7#d7 by add+ at ! end ! foll[+ new      
p>agraph3  7#b7 section #ahcg7;i77#e71 !

 cov]age p]iod %all beg9 on ! fir/ day (
 ! mon? foll[+ ! mon? 9 :i* ! individual
 s enrolls4  4  7c7 ,no increase 9      
premiums ,section #ahci7;b7 ( su* ,act  
7#db ,u4,s4,c4 #acier7b77 is am5d$ 9 !  
fir/ s5t5ce1 by ins]t+ 1 7i77#e71 aft]  
subsection 7i77#d74  #ajg4 ,special     
,m$ic>e rules dur+ ! ,,covid-#ai em]g5cy
  7a7 ,premiums ,not)/&+ any o!r        
provision ( law1 ! ,secret>y %all       
provide t an individual entitl$ to      
b5efits "u "p ,a or enroll$ "u "p ,b (  
title ,,xviii ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acie et seq47 is n     
requir$ to pay any premium "u su* "p ,a 
or "p ,b 7if any w\ld o!rwise be        
applicable7 = any mon? occurr+ dur+ !   
em]g5cy p]iod describ$ 9 section        
#aace7;g77#a77;,b7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acbj;b-#e7;g77#a77;,b774  7b7 ,co/-,%>+
 requirem5ts ,not)/&+ any o!r provision 
( law1 ) respect to items & s]vices     
furni%$ dur+ a mon? occurr+ dur+ !      
em]g5cy p]iod describ$ 9 section        

#aace7;g77#a77;,b7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acbj;b-#e7;g77#a77;,b77 to an          
individual entitl$ to b5efits "u "p ,a  
or enroll$ "u "p ,b ( title ,,xviii ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#acie et seq471 includ+ an individual   
enroll$ "u section #ahii;,c ( su* ,act1 
! ,secret>y ( ,heal? & ,human ,s]vices  
%all ensure t ! aggregate am\nt ( any   
co/-%>+ requirem5ts 7includ+ any        
d$uctibles1 copaym5ts1 or co9surance7   
applicable "u su* "p ,a or "p ,b 7or1 9 
! case ( an individual enroll$ "u "p ,c 
( su* title1 "u su* "p ,c if su* item or
 s]vice w\ld h be5 cov]$ "u su* "p ,a or
 ,b7 to su* individual ) respect to su* 
items & s]vices furni%$ dur+ su* mon?   
does n exce$ #e p]c5t ( su* individual's
 income dur+ su* mon?4 ,! ,secret>y %all
 pay to ! entity furni%+ su* item or    
s]vice ! am\nt ( any su* requirem5t t   
w\ld be payable to su* entity b =       
application ( ! previ\s s5t5ce4  #ajh4  
,national cle>+h\se = ,,covid-#ai       

p]sonal protective equipm5t & o!r m$ical
 supplies  7a7 ,9 g5]al ,! ,secret>y (  
,heal? & ,human ,s]vices 79 ?is section 
ref]r$ to z ! ,secret>y7 %all e/abli% a 
national cle>+h\se = ,,covid-#ai p]sonal
 protective equipm5t & o!r m$ical       
supplies 79 ?is section ref]r$ to z !   
cle>+h\se7 ?r\gh :i* ! ,secret>y %all   
provide = ! pur*ase1 9 accordance )     
subsection 7b71 ( p]sonal protective    
equipm5t & o!r m$ical items necess>y = !
 diagnosis or treatm5t ( ,,covid-#ai    
7includ+ respirator masks1 v5tilators1  
gloves1 bodysuits1 safety glasses1 eye  
protection1 & isolation g[ns7 & !       
di/ribution ( su* equipm5t & items 9    
accordance ) subsection 7c74  7b7       
,pur*ase ( equipm5t & items ,! ,secret>y
 %all provide = ! pur*ase ( equipm5t &  
items describ$ 9 subsection 7a7 = !     
cle>+h\se ?r\gh direct negotiations )   
entities sell+ su* equipm5t or items4   
,any su* pur*ase %all be made at a rate 
n exce$+ ! am\nt payable = su* equipm5t 
or items by ! ,secret>y ( ,vet]ans      

,affairs4  7c7 ,di/ribution ,! ,secret>y
 %all provide = ! di/ribution ( equipm5t
 & items pur*as$ = ! cle>+h\se to heal? 
c>e provid]s enroll$ "u section         
#ahff7;j7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acie;cc7j77 bas$ on !   
demon/rat$ ne$ ( su* provid]s = su*     
equipm5t & items4  7d7 ,report ,!       
,secret>y %all submit to ,congressional 
,ov]sight ,commission e/abli%$ "u       
section #djbj ( division ,a ( ! ,,c>es  
,act & publi% on a public website a     
mon?ly report on exp5ditures "u ?is     
section & di/ribution ( equipm5t & items
 made ?r\gh ! cle>+h\se4 ,su* report    
%all include a breakd[n ( ! geographic  
di/ribution ( su* equipm5t & items & a  
specification ( ! types ( exp5ditures   
made "u ?is section4  ,,ii ,m$icaid &   
,,*ip  #bja4 ,m$icaid cov]age at no co/ 
%>+ ( ,,covid-#ai vacc9e & treatm5t  7a7
 ,m$icaid  7#a7 ,9 g5]al ,section       
#aije7;a77#d7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acif;d7a77#d77 is      
am5d$-- 7,a7 by /rik+ & 7,d7 & ins]t+   

7,d72 &  7,b7 by /rik+ ! semicolon at ! 
end & ins]t+ 2 7,e7 a ,,covid-#ai vacc9e
 lic5s$ "u section #cea ( ! ,public     
,heal? ,s]vice ,act & ! adm9i/ration (  
su* vacc9e2 & 7,f7 specifi$ ,,covid-#ai 
treatm5t s]vices 7z def9$ 9 section     
#ajb7;b7 ( ! ,m$ic>e ,crisis ,program   
,act ( #bjbj724  7#b7 ,prohibition ( co/
 %>+  7,a7 ,9 g5]al ,subsections 7a77#b7
 & 7b77#b7 ( section #aiaf ( ! ,social  
,security ,act 7#db ,u4,s4,c4 #acifo7   
are ea* am5d$-- 7i7 9 subp>agraph 7,f71 
by /rik+ or at ! end2  7ii7 9           
subp>agraph 7,g71 by /rik+ 2 & & ins]t+ 
1 or2 &  7iii7 by add+ at ! end ! foll[+
 subp>agraphs3  7,h7 a ,,covid-#ai      
vacc9e lic5s$ "u section #cea ( !       
,public ,heal? ,s]vice ,act & !         
adm9i/ration ( su* vacc9e2 or  7,i7 any 
specifi$ ,,covid-#ai treatm5t s]vice 7z 
def9$ 9 section #ajb7;b7 ( ! ,m$ic>e    
,crisis ,program ,act ( #bjbj72 &  4    
7,b7 ,application to alt]native co/ %>+ 
,section #aiaf;,a7b77#c77;,b7 ( !       
,social ,security ,act 7#db ,u4,s4,c4   

#acifo-#a7;b77#c77;,b77 is am5d$-- 7i7 9
 clause 7xi71 by /rik+ any visit &      
ins]t+ any s]vice2 &  7ii7 by add+ at ! 
end ! foll[+ clauses3  7xii7 ,a         
,,covid-#ai vacc9e lic5s$ "u section    
#cea ( ! ,public ,heal? ,s]vice ,act & !
 adm9i/ration ( su* vacc9e4  7xiii7 ,a  
specifi$ ,,covid-#ai treatm5t s]vice 7z 
def9$ 9 section #ajb7;b7 ( ! ,m$ic>e    
,crisis ,program ,act ( #bjbj74  4  7,c7
 ,cl>ification ,! am5dm5ts made by ?is  
subsection %all apply ) respect to a    
,/ate plan ( a t]ritory 9 ! same mann] z
 a ,/ate plan ( "o ( ! #ej ,/ates4  7b7 
,/ate p$iatric vacc9e di/ribution       
program ,section #aibh ( ! ,social      
,security ,act 7#db ,u4,s4,c4 #acifs7 is
 am5d$-- 7#a7 9 subsection 7a77#a7--    
7,a7 9 subp>agraph 7,a71 by /rik+ 2 & & 
ins]t+ a semicolon2  7,b7 9 subp>agraph 
7,b71 by /rik+ ! p]iod & ins]t+ 2 &2 &  
7,c7 by add+ at ! end ! foll[+          
subp>agraph3  7,c7 ea* vacc9e-eligible  
*ild 7z def9$ 9 subsection 7b77 is      
entitl$ to receive a ,,covid-#ai vacc9e 

f a program-regi/]$ provid] 7z def9$ 9  
subsection 7h77#h77 )\t *>ge =-- 7i7 !  
co/ ( su* vacc9e2 or  7ii7 !            
adm9i/ration ( su* vacc9e4  2  7#b7 9   
subsection 7c77#b7-- 7,a7 9 subp>agraph 
7,c77ii71 by ins]t+ 1 b may n impose a  
fee = ! adm9i/ration ( a ,,covid-#ai    
vacc9e be=e ! p]iod2 &  7,b7 by add+ at 
! end ! foll[+ subp>agraph3  7,d7 ,!    
provid] w provide & adm9i/] an approv$  
,,covid-#ai vacc9e to a vacc9e-eligible 
*ild 9 accordance ) ! same requirem5ts z
 apply "u ! prec$+ subp>agraphs to !    
provision & adm9i/ration ( a qualifi$   
p$iatric vacc9e to su* a *ild4  2 &     
7#c7 9 subsection 7d77#a71 9 ! fir/     
s5t5ce1 by ins]t+ 1 includ+ ) respect to
 a ,,covid-#ai vacc9e lic5s$ "u section 
#cea ( ! ,public ,heal? ,s]vice ,act    
be=e ! p]iod4  7c7 ,,*ip  7#a7 ,9 g5]al 
,section #bajc7;c7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acig;cc7c771 z    
am5d$ by section #fjjd7;b77#a7 ( !      
,families ,fir/ ,coronavirus ,response  
,act1 is am5d$ by add+ at ! end ! foll[+

 p>agraph3  7#aa7 ,cov]age ( ,,covid-#ai
 vacc9es & treatm5t ,! *ild heal?       
assi/ance provid$ to a t>get$ l[-income 
*ild %all include cov]age (-- 7,a7 any  
,,covid-#ai vacc9e lic5s$ "u section    
#cea ( ! ,public ,heal? ,s]vice ,act & !
 adm9i/ration ( su* vacc9e2 &  7,b7 a   
specifi$ ,,covid-#ai treatm5t s]vice 7z 
def9$ 9 section #ajb7;b7 ( ! ,m$ic>e    
,crisis ,program ,act ( #bjbj74  4  7#b7
 ,prohibition ( co/ %>+ ,section        
#bajc7;e77#b7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acig;cc7e77#b771 z     
am5d$ by section #fjjd7;b77#c7 ( !      
,families ,fir/ ,coronavirus ,response  
,act1 is am5d$-- 7,a7 9 ! p>agraph      
head]1 by ins]t+ a ,,covid-#ai vacc9e1  
,,covid-#ai treatm5t1 be=e or           
pregnancy-relat$ assi/ance2 &  7,b7 by  
/rik+ visits describ$ 9 section         
#aiaf7;a77#b77;,g71 or & ins]t+ s]vices 
describ$ 9 section #aiaf7;a77#b77;,g71  
vacc9es describ$ 9 section              
#aiaf7;a77#b77;,h71 items or s]vices    
describ$ 9 section #aiaf7;a77#b77;,i71  

or4  7d7 ,con=m+ am5dm5ts ,section #aicg
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #acifu-#g7 is am5d$-- 7#a7 9  
subsection 7a77#a77;,b71 by ins]t+ 1 "u 
subclause 7,,xxiii7 ( section           
#aijb7;a77#aj77;,a77ii71 aft] section   
#aijb7;a77#aj77;,a77i72 &  7#b7 9       
subsection 7b77#e71 by add+ be=e ! p]iod
 ! foll[+3 1 &1 effective on ! date ( ! 
enactm5t ( ! ,m$ic>e ,crisis ,program   
,act ( #bjbj1 mu/ comply ) subp>agraphs 
7,f7 ?r\gh 7,i7 ( subsections 7a77#b7 & 
7b77#b7 ( sections #aiaf & #aiaf;,a4    
7e7 ,effective date ,! am5dm5ts made by 
?is section %all take effect on ! date (
 enactm5t ( ?is ,act & %all apply )     
respect to a ,,covid-#ai vacc9e beg9n+  
on ! date t su* vacc9e is lic5s$ "u     
section #cea ( ! ,public ,heal? ,s]vice 
,act 7#db ,u4,s4,c4 #bfb74  #bjb4       
,increas+ ! tempor>y increase ( ,m$icaid
 ,,fmap dur+ ! ,,covid-#ai em]g5cy  7a7 
,9 g5]al ,section #fjjh7;a7 ( !         
,families ,fir/ ,coronavirus ,response  
,act 7,public ,law #aaf-abg7 is am5d$ by

 /rik+ #f4b & ins]t+ #ac4  7b7 ,ext5sion
 ( p]iod ( applicability ,section #fjjh 
( su* ,act is am5d$-- 7#a7 9 subsection 
7a71 by /rik+ su* em]g5cy p]iod & ins]t+
 ! specifi$ p]iod 7z def9$ 9 subsection 
7d772  7#b7 9 subsection 7b77#c7-- 7,a7 
by /rik+ ! em]g5cy p]iod & ins]t+ !     
specifi$ p]iod 7z def9$ 9 subsection    
7d772 &  7,b7 by /rik+ su* em]g5cy p]iod
 & ins]t+ su* specifi$ p]iod2 &  7#c7 by
 add+ at ! end ! foll[+ new subsection3 
7d7 ,specifi$ p]iod ,9 ?is section1 !   
t]m specifi$ p]iod means1 ) respect to a
 ,/ate1 includ+ ! ,di/rict ( ,columbia1 
,am]ican ,samoa1 ,guam1 ! ,commonweal? (
 ! ,nor!rn ,m>iana ,isl&s1 ,pu]to ,rico1
 & ! ,unit$ ,/ates ,virg9 ,isl&s1 !     
p]iod beg9n+ on ! fir/ day ( ! em]g5cy  
p]iod describ$ 9 subsection 7a7 & end+  
on ! date t is #c mon?s aft] ! fir/ day 
occurr+ on or aft] ! date ( ! enactm5t (
 ?is section t ! av]age unemploym5t rate
 = ! #ab-mon? p]iod end+ on su* fir/    
day-- 7#a7 9 su* ,/ate is n m ?an #b    
p]c5tage po9ts high] t ! av]age         

unemploym5t rate 9 su* ,/ate dur+ !     
p]iod consi/+ ( ,octob] #a ?r\gh        
,decemb] #ca ( #bjai2 &  7#b7 9 ! ,unit$
 ,/ates is n m ?an #b p]c5tage po9ts    
high] t ! av]age unemploym5t rate 9 !   
,unit$ ,/ates dur+ ! p]iod consi/+ (    
,octob] #a ?r\gh ,decemb] #ca ( #bjai4  
4  #bjc4 ,increas+ ,f$]al support to    
,/ate ,m$icaid programs dur+ economic   
d[nturns  7a7 ,9 g5]al ,section #aije ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#acif;d7 is am5d$-- 7#a7 9 subsection   
7b71 by /rik+ & 7ff7 & ins]t+ 7ff71 &   
7gg72 &  7#b7 by add+ at ! end ! foll[+ 
new subsection3  7gg7 ,increas$ ,,fmap  
dur+ economic d[nturns  7#a7 ,9 g5]al   
,not)/&+ subsection 7b71 7y71 or        
7z77#b71 if a fiscal qu>t] t beg9s on or
 aft] ,janu>y #a1 #bjbj1 is an economic 
d[nturn qu>t] 7z def9$ 9 p>agraph 7#b77 
) respect to a ,/ate1 !n ! ,f$]al m$ical
 assi/ance p]c5tage applicable to am\nts
 exp5d$ by ! ,/ate = m$ical assi/ance = 
s]vices furni%$ dur+ su* qu>t] %all be  
increas$ 9 accordance ) p>agraphs 7#c7 &

 7#d74  7#b7 ,economic d[nturn qu>t]    
7,a7 ,9 g5]al  7i7 ,9 g5]al ,9 ?is      
subsection1 ! t]m economic d[nturn qu>t]
 means1 ) respect to a ,/ate1 a fiscal  
qu>t] dur+ :i* ! ,/ate's unemploym5t    
rate = ! qu>t] exce$s ! p]c5tage det]m9$
 = ! ,/ate & qu>t] "u clause 7ii74  7ii7
 ,?re%old p]c5tage ,! p]c5tage det]m9$  
"u ?is clause = a ,/ate & fiscal qu>t]  
is ! p]c5tage equal to ! l[] (-- 7,i7 ! 
,/ate unemploym5t rate at ! #bj?        
p]c5tile ( ! di/ribution ( ! ,/ate's    
qu>t]ly unemploym5t rates = ! #fj-qu>t] 
p]iod prec$+ ! qu>t] involv$1 increas$  
by #a p]c5tage po9t2 &  7,,ii7 ! ,/ate's
 av]age qu>t]ly unemploym5t rate = !    
#ab-qu>t] p]iod prec$+ ! qu>t] involv$1 
increas$ by #a p]c5tage po9t4  7,b7     
,unemploym5t data  7i7 ,9 g5]al ,except 
z provid$ 9 clause 7ii71 = purposes (   
det]m9+ unemploym5t rates = a ,/ate & a 
qu>t] "u ?is p>agraph1 ! ,secret>y %all 
use data f ! ,local ,area ,unemploym5t  
,/ati/ics f ! ,bureau ( ,labor          
,/ati/ics4  7ii7 ,application to c]ta9  

t]ritories ,9 ! case ( ! ,virg9 ,isl&s1 
,guam1 ! ,nor!rn ,m>iana ,isl&s1 or     
,am]ican ,samoa1 ! ,secret>y %all use   
data f ! ,u-#f unemploym5t measure ( !  
,bureau ( ,labor ,/ati/ics to make any  
necess>y det]m9ations "u subp>agraph    
7,a74  7#c7 ,,fmap increase dur+        
economic d[nturn qu>t]  7,a7 ,9 g5]al   
,dur+ a fiscal qu>t] t is an economic   
d[nturn qu>t] ) respect to a ,/ate1 !   
,f$]al m$ical assi/ance p]c5tage o!rwise
 det]m9$ = ! ,/ate & qu>t] "u subsection
 7b7 &1 if applicable1 ! ,f$]al m$ical  
assi/ance p]c5tage applicable "u        
subsection 7y71 7z77#b71 or 7ff7 )      
respect to m$ical assi/ance furni%$ by !
 ,/ate dur+ su* qu>t] to individuals    
describ$ 9 ei!r su* subsection %all be  
increas$ by ! numb] ( p]c5tage po9ts    
7r\nd$ to ! ne>e/ t5? ( a p]c5tage po9t7
 equal to ! product (-- 7i7 ! numb] (   
p]c5tage po9ts 7r\nd$ to ! ne>e/ t5? ( a
 p]c5tage po9t7 by :i* ! unemploym5t    
rate = ! ,/ate & qu>t] exce$s ! p]c5tage
 det]m9$ = ! ,/ate & qu>t] "u p>agraph  

7#b77;,a77ii72 &  7ii7 #d4h4  7,b7      
,application ( ,,covid-#ai ,,fmap       
increase ,any increase applicable to !  
,f$]al m$ical assi/ance p]c5tage ( a    
,/ate = a fiscal qu>t] "u subp>agraph   
7,a7 %all be 9 addition to any increase 
to su* p]c5tage = su* qu>t] made        
pursuant to section #fjjh7;a7 ( !       
,families ,fir/ ,coronavirus ,response  
,act4  7,c7 ,limitation ,9 no case %all 
an increase to ! ,f$]al m$ical assi/ance
 p]c5tage ( a ,/ate "u ?is p>agraph     
result 9 a ,f$]al m$ical assi/ance      
p]c5tage t exce$s #ie p]c5t4  7,d7      
,scope ( application ,any increase to ! 
,f$]al m$ical assi/ance p]c5tage ( a    
,/ate = a fiscal qu>t] "u ?is p>agraph  
%all only apply ) respect to paym5ts =  
am\nts exp5d$ by ! ,/ate = m$ical       
assi/ance = s]vices furni%$ dur+ su*    
qu>t] & %all n apply ) respect to-- 7i7 
disproportionate %>e hospital paym5ts   
describ$ 9 section #aibc2  7ii7 paym5ts 
"u title ,,iv or ,,xxi2  7iii7 any      
paym5ts "u ?is title t are bas$ on !    

enhanc$ ,,fmap describ$ 9 section       
#baje7;b72 or  7iv7 any paym5ts "u ?is  
title t are bas$ on a ,f$]al m$ical     
assi/ance p]c5tage det]m9$ = a ,/ate "u 
subsection 7aa7 7b only to ! ext5t t su*
 ,f$]al m$ical assi/ance p]c5tage is    
high] ?an ! economic recov]y ,,fmap74   
7#d7 ,advance paym5t2 retrospective     
adju/m5t  7,a7 ,9 g5]al ,prior to !     
beg9n+ ( ea* fiscal qu>t] t beg9s on or 
aft] ,july #a1 #bjbj1 ! ,secret>y %all1 
) respect to ea* ,/ate-- 7i7 det]m9e !  
increase 7if any7 t is expect$ to apply 
to ! ,f$]al m$ical assi/ance p]c5tage ( 
su* ,/ate = su* qu>t] "u ?is subsection 
bas$ on ! projections made = ! ,/ate &  
qu>t] "u subp>agraph 7,b72 &  7ii7 %all 
apply su* increase to ! ,f$]al m$ical   
assi/ance p]c5tage ( ! ,/ate = purposes 
( mak+ paym5ts to ! ,/ate = am\nts      
exp5d$ dur+ su* qu>t] z m$ical assi/ance
 "u ! ,/ate plan4  7,b7 ,projection (   
,/ate unemploym5t rates ,prior to !     
beg9n+ ( ea* fiscal qu>t] t beg9s on or 
aft] ,july #a1 #bjbj1 ! ,secret>y1 act+ 

?r\gh ! ,*ief ,actu>y ( ! ,c5t]s =      
,m$ic>e  ,m$icaid ,s]vices1 %all1 us+ ! 
mo/ rec5tly available data describ$ 9   
p>agraph 7#b77;,b71 make projections )  
respect to-- 7i7 ! unemploym5t rates =  
ea* ,/ate = su* qu>t]2  7ii7 ! ?re%old  
p]c5tages describ$ 9 p>agraph           
7#b77;,a77ii7 = ea* ,/ate = su* qu>t]2 &
  7iii7 ! national unemploym5t rate =   
su* qu>t]4  7,c7 ,retrospective adju/m5t
 ,z soon z practicable aft] f9al        
unemploym5t data becomes available = a  
fiscal qu>t] t beg9s on or aft] ,july   
#a1 #bjbj1 ! ,secret>y %all1 ) respect  
to ea* ,/ate-- 7i7 make a f9al          
det]m9ation ( ! increase 7if any7       
applicable to ! ,f$]al m$ical assi/ance 
p]c5tage ( ! ,/ate = ! qu>t] "u ?is     
subsection2 &  7ii7 9 accordance )      
subsection 7d77#b7 ( section #aijc1     
r$uce or increase ! am\nt payable to !  
,/ate "u subsection 7a7 ( su* section = 
a subsequ5t fiscal qu>t] to ! ext5t (   
any ov]paym5t or und]paym5t :i* !       
,secret>y det]m9es 0 made z a result ( a

 miscalculation ( ! increase applicable 
to ! ,f$]al m$ical assi/ance p]c5tage ( 
! ,/ate = su* prior fiscal qu>t] "u ?is 
subsection4  7#e7 ,retrospective        
application ( ov]-!-limit ,,fmap        
increases  7,a7 ,9 g5]al ,if a ,/ate has
 excess p]c5tage po9ts ) respect to an  
economic d[nturn qu>t] & an applicable  
,,fmap 7z det]m9$ "u subp>agraph 7,b771 
! ,/ate may elect to apply su* excess   
p]c5tage po9ts to increase su*          
applicable ,,fmap = "o or m qu>t]s dur+ 
! look-back p]iod = ! ,/ate & economic  
d[nturn qu>t] 9 accordance ) ?is        
p>agraph4  7,b7 ,excess p]c5tage po9ts  
,= purposes ( ?is p>agraph1 ! numb] (   
excess p]c5tage po9ts = a ,/ate1        
economic d[nturn qu>t]1 & an applicable 
,,fmap %all be equal to ! numb] (       
p]c5tage po9ts by :i*-- 7i7 ! applicable
 ,,fmap = ! ,/ate & qu>t] 7aft]         
application ( p>agraph 7#c7 b )\t reg>d 
to subp>agraph 7,c7 ( su* p>agraph72    
exce$s  7ii7 #ie p]c5t4  7,c7 ,effect ( 
application ( excess p]c5tage po9ts ,if 

a ,/ate elects to apply excess p]c5tage 
po9ts to an applicable ,,fmap to a qu>t]
 dur+ a look-back p]iod "u ?is p>agraph1
 ! ,secret>y %all det]m9e ! additional  
am\nt ( paym5t "u section #aijc7;a7 to  
:i* ! ,/ate w\ld h be5 entitl$ = su*    
qu>t] if ! applicable ,,fmap 7z s       
increas$7 _h be5 9 effect = su* qu>t]1 &
 %all treat su* additional am\nt z an   
und]paym5t = su* qu>t]4  7,d7           
,di/ribution ( excess p]c5tage po9ts ,a 
,/ate t has excess p]c5tage po9ts )     
respect to an economic d[nturn qu>t] &  
applicable ,,fmap may elect to divide   
su* po9ts among m ?an #a qu>t] dur+ !   
look-back p]iod = su* ,/ate & qu>t]     
provid$ t no excess p]c5tage po9t 7or   
fraction ( an excess p]c5tage po9t7 is  
appli$ to ! applicable ,,fmap ( m ?an #a
 qu>t]4  7,e7 ,limitations  7i7 ,no     
increases ov] #ajj p]c5t ,a ,/ate may n 
increase an applicable ,,fmap = any     
qu>t] dur+ a look-back p]iod "u ?is     
p>agraph if su* increase w\ld result 9 !
 applicable ,,fmap = su* qu>t] exce$+   

#ajj p]c5t4  7ii7 ,scope ( application  
,any increase to an applicable ,,fmap ( 
a ,/ate = a fiscal qu>t] "u ?is         
p>agraph-- 7,i7 %all only apply )       
respect to paym5ts = am\nts exp5d$ by ! 
,/ate = m$ical assi/ance = s]vices      
furni%$ dur+ su* qu>t] to :i* su*       
applicable ,,fmap is applicable2 &      
7,,ii7 %all n apply ) respect to paym5ts
 describ$ 9 p>agraph 7#c77;,d74  7,f7   
,def9itions ,9 ?is p>agraph3 7i7        
,applicable ,,fmap ,! t]m applicable    
,,fmap means1 ) respect to a ,/ate &    
fiscal qu>t]-- 7,i7 ! ,f$]al m$ical     
assi/ance p]c5tage det]m9$ = ! ,/ate &  
qu>t] "u subsection 7b72  7,,ii7 !      
,f$]al m$ical assi/ance p]c5tage        
applicable "u subsection 7y72  7,,iii7 !
 ,f$]al m$ical assi/ance p]c5tage       
applicable "u subsection 7z77#b72 or    
7,,iv7 ! ,f$]al m$ical assi/ance        
p]c5tage det]m9$ = ! ,/ate & qu>t] "u   
subsection 7ff74  7ii7 ,look-back p]iod 
,! t]m look-back p]iod means1 ) respect 
to a ,/ate & a fiscal qu>t] t is an     

economic d[nturn qu>t] = ! ,/ate1 !     
p]iod ( #d fiscal qu>t]s t ends ) ! f\r?
 qu>t] :i* prec$es ! mo/ rec5t fiscal   
qu>t]s t 0 n an economic d[nturn qu>t] =
 ! ,/ate4  7#f7 ,requirem5t = all ,/ates
 ,a ,/ate may n receive an increase 9 ! 
,f$]al m$ical assi/ance p]c5tage = su*  
,/ate "u ?is subsection1 ) respect to a 
fiscal qu>t]1 if-- 7,a7 eligibility     
/&>ds1 me?odologies1 or proc$ures "u !  
,/ate plan or a waiv] ( su* plan are m  
re/rictive dur+ su* qu>t] ?an !         
eligibility /&>ds1 me?odologies1 or     
proc$ures1 respectively1 "u su* plan 7or
 waiv]7 z 9 effect on ! la/ day ( ! mo/ 
rec5t fiscal qu>t] t 0 n an economic    
d[nturn qu>t] = ! ,/ate2  7,b7 ! am\nt (
 any premium impos$ by ! ,/ate pursuant 
to section #aiaf or #aiaf;,a dur+ su*   
qu>t]1 ) respect to an individual       
enroll$ "u su* plan 7or waiv]71 exce$s !
 am\nt ( su* premium z ( ! date describ$
 9 subp>agraph 7,a72 or  7,c7 ! ,/ate   
fails to provide t an individual :o is  
enroll$ = b5efits "u su* plan 7or waiv]7

 z ( ! date describ$ 9 subp>agraph 7,a7 
or enrolls = b5efits "u su* plan 7or    
waiv]7 dur+ ! p]iod beg9n+ ) su* date & 
end+ ) ! day be=e ! fir/ day ( ! next   
qu>t] t is n an economic d[nturn qu>t] =
 ! ,/ate %all be treat$ z eligible = su*
 b5efits = n less ?an #ab mon?s 7or1 if 
su* p]iod is less ?an #ab mon?s1 ?r\gh\t
 su* p]iod7 unless ! individual reque/s 
a volunt>y t]m9ation ( eligibility or ! 
individual ceases to be a resid5t ( !   
,/ate4  4  7b7 ,exclusion ( economic    
d[nturn ,,fmap increases f t]ritorial   
caps ,section #aajh ( ! ,social         
,security ,act 7#db ,u4,s4,c4 #acjh7 is 
am5d$-- 7#a7 9 subsection 7f71 9 ! matt]
 prec$+ p>agraph 7#a71 by /rik+         
subsection 7g7 & section                
#aice7;e77#a77;,b7 & ins]t+ subsections 
7g7 & 7h7 & section #aice7;e77#a77;,b72 
&  7#b7 by add+ at ! end ! foll[+3  7h7 
,exclusion f caps ( am\nts attributable 
to economic d[nturn ,,fmap ,! portion ( 
any paym5t made to a t]ritory = a fiscal
 ye> t is attributable to an increase 9 

! ,f$]al m$ical assi/ance p]c5tage = a  
fiscal qu>t] dur+ su* ye> "u section    
#aije7;gg7 %all n be tak5 into acc\nt = 
purposes ( apply+ paym5t limits "u      
subsections 7f7 & 7g74  4  #bjd4 #ajj   
p]c5t ,,fmap = individuals enroll+ "u   
,m$icaid dur+ ! ,,covid-#ai em]g5cy  7a7
 ,9 g5]al ,not)/&+ any o!r provision (  
law1 ! ,f$]al m$ical assi/ance p]c5tage 
o!rwise det]m9$ "u section #aije7;b7 ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#acif;d7b77 ) respect to m$ical         
assi/ance furni%$ dur+ a specifi$ p]iod 
to a specifi$ individual "u a ,/ate plan
 7or waiv] ( su* plan7 "u title ,,xix ( 
su* ,act %all be #ajj p]c5t4  7b7       
,def9itions ,9 ?is section3 7#a7        
,specifi$ individual ,! t]m specifi$    
individual means an individual :o       
enrolls "u ! ,/ate plan 7or waiv] ( su* 
plan7 "u title ,,xix ( ! ,social        
,security ,act 7#db ,u4,s4,c4 #acif et  
seq47 dur+ ! em]g5cy p]iod describ$ 9   
section #aace7;g77#a77;,b7 ( su* ,act   
7#db ,u4,s4,c4 #acbj;b-#e7;g77#a77;,b774

  7#b7 ,specifi$ p]iod ,! t]m specifi$  
p]iod means1 ) respect to a ,/ate1      
includ+ ! ,di/rict ( ,columbia1 ,am]ican
 ,samoa1 ,guam1 ! ,commonweal? ( !      
,nor!rn ,m>iana ,isl&s1 ,pu]to ,rico1 & 
! ,unit$ ,/ates ,virg9 ,isl&s1 ! p]iod  
beg9n+ on ! fir/ day ( ! em]g5cy p]iod  
describ$ 9 subsection 7a7 & end+ on !   
date t is #c mon?s aft] ! fir/ day      
occurr+ on or aft] ! date ( ! enactm5t (
 ?is section t ! av]age unemploym5t rate
 = ! #ab-mon? p]iod end+ on su* fir/    
day-- 7,a7 9 su* ,/ate is n m ?an #b    
p]c5tage po9ts high] t ! av]age         
unemploym5t rate 9 su* ,/ate dur+ !     
p]iod consi/+ ( ,octob] #a ?r\gh        
,decemb] #ca ( #bjai2 &  7,b7 9 ! ,unit$
 ,/ates is n m ?an #b p]c5tage po9ts    
high] t ! av]age unemploym5t rate 9 !   
,unit$ ,/ates dur+ ! p]iod consi/+ (    
,octob] #a ?r\gh ,decemb] #ca ( #bjai4  
#bje4 ,m&atory approval ( waiv]s to cov]
 c]ta9 individuals "u ,m$icaid dur+ !   
,,covid-#ai em]g5cy ,section #aaae7;d7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4

 #acae7;d77 is am5d$ by add+ at ! end ! 
foll[+ new p>agraph3  7#d7 ,not)/&+ any 
o!r provision ( ?is section1 ! ,secret>y
 %all approve an application = a        
demon/ration project "u ?is section to !
 ext5t t su* project all[s an individual
 ^: income 7z det]m9$ "u section        
#aijb7;e77#ad77 does n exce$ #cjj p]c5t 
( ! pov]ty l9e 7z def9$ 9 section       
#baaj7;c77#e77 applicable to a family ( 
! size involv$1 to enroll "u ! ,/ate    
plan 7or waiv] ( su* plan7 "u title     
,,xix ( ! ,/ate submitt+ su*            
application4  4  ,,iii ,miscellane\s    
#cja4 ,gr\p heal? plan & heal? insurance
 issu] cov]age ( ,,covid-#ai relat$     
treatm5t at no co/ %>+  7a7 ,9 g5]al ,a 
gr\p heal? plan & a heal? insurance     
issu] (f]+ gr\p or individual heal?     
insurance cov]age 7includ+ a gr&fa!r$   
heal? plan 7z def9$ 9 section #abea7;e7 
( ! ,pati5t ,protection & ,af=dable ,c>e
 ,act77 %all provide cov]age1 & %all n  
impose any co/ %>+ 7includ+ d$uctibles1 
copaym5ts1 & co9surance7 requirem5ts1 = 

specifi$ ,,covid-#ai treatm5t s]vices 7z
 def9$ 9 section #ajb7;b77 furni%$ dur+ 
any portion ( ! em]g5cy p]iod def9$ 9   
p>agraph 7#a77;,b7 ( section #aace7;g7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #acbj;b-#e7;g77 beg9n+ on or aft] !    
date ( ! enactm5t ( ?is ,act4  7b7      
,reimbursem5t to plans & cov]age = waiv+
 co/ %>+  7#a7 ,9 g5]al ,a gr\p heal?   
plan or a heal? insurance issu] (f]+    
gr\p or individual heal? insurance      
cov]age 7includ+ a gr&fa!r$ heal? plan  
7z def9$ 9 section #abea7;e7 ( ! ,pati5t
 ,protection & ,af=dable ,c>e ,act77 t  
does n impose co/ %>+ requirem5ts z     
describ$ 9 subsection 7a7 %all notify ! 
,secret>y ( ,heal? & ,human ,s]vices1   
,secret>y ( ,labor1 & ,secret>y ( !     
,treasury 7?r\gh a jo9t process e/abli%$
 jo9tly by ! ,secret>ies7 ( ! total     
doll> am\nt ( co/ %>+ t1 b = !          
application ( subsection 7a71 w\ld h be5
 requir$ "u su* plans & cov]age = items 
& s]vices relat$ to ,,covid-#ai furni%$ 
dur+ ! p]iod to :i* subsection 7a7      

applies to enrollees1 p>ticipants1 &    
b5efici>ies 9 ! plan or cov]age to :om  
su* subsection applies1 b :i* 0 n impos$
 = su* items & s]vices s furni%$        
pursuant to su* subsection & ! ,secret>y
 ( ,heal? & ,human ,s]vices1 9          
coord9ation ) ! ,secret>y ( ,labor & !  
,secret>y ( ! ,treasury1 %all make      
paym5ts 9 accordance ) ?is subsection to
 ! plan or issu] equal to su* total     
doll> am\nt4  7#b7 ,me?odology = paym5ts
 ,! ,secret>y ( ,heal? & ,human         
,s]vices1 9 coord9ation ) ! ,secret>y ( 
,labor & ! ,secret>y ( ! ,treasury %all 
e/abli% a paym5t sy/em = mak+ paym5ts "u
 ?is subsection4 ,any su* sy/em %all    
make paym5t = ! value ( co/ %>+ n impos$
 by ! plan or issu] involv$4  7#c7 ,tim+
 ( paym5ts ,paym5ts made "u p>agraph    
7#a7 %all be made no lat] ?an ,may #a1  
#bjba1 = am\nts ( co/ %>+ waiv]s )      
respect to #bjbj4 ,paym5ts "u ?is       
subsection ) respect to su* waiv]s )    
respect to a ye> subsequ5t to #bjbj t   
beg9s dur+ ! p]iod to :i* subsection 7a7

 applies %all be made no lat] ?an ,may (
 ! ye> foll[+ su* subsequ5t ye>4  7#d7  
,appropriations ,!re is au?oriz$ to be  
appropriat$1 & !re is appropriat$1 out (
 any monies 9 ! ,treasury n o!rwise     
appropriat$1 su* funds z are necess>y to
 c>ry out ?is subsection4  7c7 ,en=cem5t
  7#a7 ,application ) respect to ,,phsa1
 ,,erisa1 & ,,irc ,! provisions ( ?is   
section %all be appli$ by ! ,secret>y ( 
,heal? & ,human ,s]vices1 ,secret>y (   
,labor1 & ,secret>y ( ! ,treasury to    
gr\p heal? plans & heal? insurance      
issu]s (f]+ gr\p or individual heal?    
insurance cov]age z if includ$ 9 !      
provisions ( "p ,a ( title ,,xxvii ( !  
,public ,heal? ,s]vice ,act1 "p #g ( !  
,employee ,retirem5t ,income ,security  
,act ( #aigd1 & sub*apt] ,b ( *apt] #ajj
 ( ! ,int]nal ,rev5ue ,code ( #aihf1 z  
applicable4  7#b7 ,private "r ( action  
,an individual ) respect to :om an      
action is tak5 by a gr\p heal? plan or  
heal? insurance issu] (f]+ gr\p or      
individual heal? insurance cov]age 9    

violation ( subsection 7a7 may comm5ce a
 civil action aga9/ ! plan or issu] =   
appropriate relief4 ,! previ\s s5t5ce   
%all n be con/ru$ z limit+ any en=cem5t 
me*anism o!rwise applicable pursuant to 
p>agraph 7#a74  7d7 ,implem5tation ,!   
,secret>y ( ,heal? & ,human ,s]vices1   
,secret>y ( ,labor1 & ,secret>y ( !     
,treasury may implem5t ! provisions (   
?is section ?r\gh sub-regulatory        
guidance1 program in/ruction1 or        
o!rwise4  7e7 ,t]ms ,9 ?is section1 !   
t]ms gr\p heal? plan1 heal? insurance   
issu]1 gr\p heal? insurance cov]age1 &  
individual heal? insurance cov]age h !  
mean+s giv5 su* t]ms 9 section #bgia ( !
 ,public ,heal? ,s]vice ,act 7#db       
,u4,s4,c4 #cjj;gg-#ia71 section #gcc ( !
 ,employee ,retirem5t ,income ,security 
,act ( #aigd 7#bi ,u4,s4,c4 #aaia;b71 & 
section #ihcb ( ! ,int]nal ,rev5ue ,code
 ( #aihf1 z applicable4  #cjb4 ,paym5t =
 specifi$ ,,covid-#ai treatm5t s]vices  
furni%$ to ! un9sur$  7a7 ,9 g5]al ,!   
,secret>y ( ,heal? & ,human ,s]vices    

%all pay to a heal? c>e provid] t       
furni%es a specifi$ ,,covid-#ai treatm5t
 s]vice 7z def9$ 9 section #ajb7 to an  
un9sur$ individual 7z def9$ 9 subsection
 7b77 an am\nt equal to ! am\nt t w\ld h
 be5 payable 7includ+ any co/-%>+       
requirem5t7 "u title ,,xviii ( ! ,social
 ,security ,act 7#db ,u4,s4,c4 #acie et 
seq47 _h su* s]vice be5 furni%$ to an   
individual entitl$ to b5efits "u "p ,a &
 enroll$ "u "p ,b ( su* title4  7b7     
,un9sur$ individual ,= purposes ( ?is   
section1 ! t]m un9sur$ individual means 
an individual :o-- 7#a7 is n enroll$ 9 a
 gr\p heal? plan or 9 gr\p or individual
 heal? insurance cov]age 7z def9$ 9     
section #bgia ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4 #cjj;gg-#ia772 &   
7#b7 is n enroll$ 9 a ,f$]al heal? c>e  
program 7z def9$ 9 section #aabh;,b7f7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #acbj;a-#g;b7f777 or "u ! program      
e/abli%$ "u *apt] #hi ( title #e1 ,unit$
 ,/ates ,code4  7c7 ,hold+ un9sur$      
individual h>mless = specifi$           

,,covid-#ai treatm5t s]vices  7#a7 ,9   
g5]al ,a heal? c>e provid] receiv+      
paym5t "u subsection 7a7 = a specifi$   
,,covid-#ai treatm5t s]vice furni%$ to  
an individual may n hold su* individual 
liable = any am\nt = su* s]vice4  7#b7  
,en=cem5t ,a heal? c>e provid] :o       
violates subsection 7a7 %all be subject 
to a civil monet>y p5alty det]m9$       
appropriate by ! ,secret>y ( ,heal? &   
,human ,s]vices4 ,! provision ( section 
#aabh;,a ( ! ,social ,security ,act 7#db
 ,u4,s4,c4 #acbj;a-#g;a7 7o!r ?an       
subsections 7a7 & 7b77 %all apply )     
respect to a civil monet>y p5alty impos$
 "u ! previ\s s5t5ce 9 ! same mann] z   
su* provisions apply ) respect to a     
p5alty or proce$+ "u subsection 7a7 (   
su* section4